A survey by the Kaiser Family Foundation found two-thirds of respondents were in favor of the new requirement for insurance plans to offer prescription birth control without a copay or deductible.
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A survey by the Kaiser Family Foundation found two-thirds of respondents were in favor of the new requirement for insurance plans to offer prescription birth control without a copay or deductible.

Hamiza Bakirci/iStockphoto.com

It used to be that opposition to publicly funded birth control was linked to abortion.

Either the birth control in question allegedly caused abortion, or the organization providing the birth control (read: Planned Parenthood) also performed abortions. But that's changing.

These days, more and more voices are opposing the provision of birth control for its own sake.

"They've called it preventative medicine. Preventative medicine," said Rep. Steve King, R-Iowa, on the House floor last month, shortly after the Obama administration adopted the recommendations of an expert panel and agreed to add contraceptives to a list of services insurance plans will be required to provide without a deductible or copayment. "Well, if you apply that preventative medicine universally, what you end up with is you've prevented a generation. Preventing babies from being born is not medicine."

Some opponents, like conservative commentator Sandy Rios, say subsidizing birth control is simply too expensive in an era of tight budgets. "We have $14 trillion in debt, and now we're going to cover birth control?" she said on Fox News, adding, "Are we going to do pedicures and manicures as well? I think that would be a good idea."

Others, such as Jeffrey Kuhner, president of the conservative Edmund Burke Institute, say birth control is no less than an affront to God. "In short, liberals want to create a world without God and sexual permissiveness is their battering ram. Promoting widespread contraception is essential to forging a pagan society based on consequence-free sex," he wrote in an opinion piece for the Washington Times.

Still others, like Marjorie Dannenfelser, of the anti-abortion Susan B. Anthony List, insist that providing birth control doesn't even work at preventing abortions.

"As the money (for family planning) goes up, so do the number of abortions," she said. "We have not seen a reduction in abortions since the full funding of family planning. We have seen an escalation."

But that's simply not the case, says Emily Stewart, director of public policy for Planned Parenthood.

"Without a doubt, when women have access to birth control, it reduces unintended pregnancies," Stewart said. "The truth is we need to do more. And Americans agree that we need to do more to improve access to birth control."

Abortion opponents are correct that widespread access to birth control hasn't eliminated abortions in the U.S. — although the number has declined considerably over the last two decades.

But supporters of birth control like Stewart say the reason is that there hasn't been enough access to contraception. Funding for Title X, the federal government's main family planning program, has largely remained flat — mostly due to abortion-related fights. So it hasn't kept up with inflation or population growth. As a result, Stewart says, "millions and millions of Americans in need of publicly funded family planning services today are not getting access to family planning services."

But Helen Alvare, a law professor at George Mason University, says she thinks there may be yet another reason why widespread use of birth control hasn't brought down the rate of unintended pregnancy more dramatically – something economists call risk compensation.

"If you lower the cost of things, people will buy more of it," she says. So "if you lower the cost of uncommitted sexual encounters, you completely dissociate sex from pregnancy and birth and a lifetime of child care. People will engage in more uncommitted sexual encounters."

And because birth control is not perfect, and people don't use it perfectly or consistently, she says, that will result in more unintended pregnancies.

Still, the question remains, why is it only now that objections to birth control are being raised in public? John Green, a political science professor who studies religion and politics at the University of Akron, says he thinks it has a lot to do with the recent battles over federal spending in general, and the new health law in particular.

"I think for a lot of conservative activists, it's almost as if a bit of a threshold has been crossed in the debate," he said. "Because they believe that at least in this area, the public sector has become a little larger than it should be and is threatening some of the basic values that they hold."

But while calls to end federal funding for contraception may be on the rise, the public remains strongly on the other side, at least for now. A survey released last week by the Kaiser Family Foundation found two-thirds of respondents in favor of the new requirement for insurance plans to offer prescription birth control without a copay or deductible.

Shots is the online channel for health stories from the NPR Science Desk. We report on news that can make a difference for your health and show how policy shapes our health choices. Look to Shots for the latest on research and medical treatments, as well as the business side of health. Your hosts are Scott Hensley and Nancy Shute. You can reach the Shots team via our contact form.